Priscilla Evans, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149022883 Issued in IL

Practice address

11111 S Western Ave
Chicago, IL 60643-3907

Phone

(773) 238-1100

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Expansive Health and Recovery Services Inc.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1730858440

  Clinical

  NPD Authorized official
• Brenda T. Thompson

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1033654439

  Clinical

  NPD (past)
• The Branch Family Institute, Inc.

  • Voluntary or Charitable Agency
  • Chicago, IL
  • NPI 1366880429
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1245828987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 W 97TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052611",
            "telephone_number": "773-931-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433907",
            "telephone_number": "773-238-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2935 W 97th St",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608052611",
            "country_code": "US",
            "telephone_number": "773-931-1302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "PRISCILLA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Allan Evans, M.D.
• Nicole Evans
• Paul Thomas Evans, CADC
• Petulia Evans
• Phyllis Anita Evans, NURSE PRACTITIONER
• Renee Evans, APN
• Stephanie Evans
• Stephanie Ann Evans, LCPC
• Stephanie C Evans, FNP
• Thelma Evans, M.D.

• All providers in Chicago, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.